Coronary artery disease is the leading cause of death in this country for both men and women, killing more than 500,000 people every year, according to the National Heart Lung and Blood Institute. Most people probably want to avoid heart surgery if they can. But what are the steps you need to take to reduce your risk for heart disease? And if that doesn't work, what types of treatments are available?

"There are ways to lower your risk for heart disease and prevent some of the serious complications," said Dr. Michael Parmley, an internist and member of the Washington Hospital staff. "Diet and exercise play a big role."

In recognition of American Heart Month, Parmley will join Dr. Jon-Cecil Walkes, a cardiothoracic surgeon and chief of Cardiothoracic Surgery at Washington Hospital, for a seminar on the prevention and treatment of heart disease. "Coronary Artery Disease: Heart Surgery Options" is scheduled for Tuesday, February 15, from 1 to 3 p.m. The free seminar will be held at the Conrad E. Anderson, M.D. Auditorium at Washington West, located at 2500 Mowry Avenue in Fremont. You can register online at www.whhs.com or call (800) 963-7070 for more information.

During the first half of the seminar, Parmley will talk about ways to reduce the risk for coronary artery disease, which occurs when the arteries are narrowed by the buildup of a substance called plaque on the inner walls of the artery, restricting the flow of blood to the heart.

Cholesterol Counts

Reducing blood cholesterol is important, especially for those who are already at risk for heart disease, including those with diabetes and high blood pressure, according to Parmley. Cholesterol is a waxy, fat-like substance that is found in all cells. Our bodies need cholesterol to produce hormones, vitamin D, and other substances that help with digestion. But too much of it can be a problem.

He will talk about the difference between good (HDL) and bad (LDL) cholesterol and how they affect the body. While LDL can build up on the walls of the arteries, HDL transports unused cholesterol back to the liver.

"Good cholesterol may end up being more important than bad cholesterol in the long run," Parmley said. "Preliminary studies show that it can reduce the amount of bad cholesterol in the arteries, but more research is needed to better understand the role of good cholesterol."

Parmley will explain optimum blood cholesterol levels, particularly for those who have other risk factors, and ways to reduce bad cholesterol, including diet and exercise. He said eating a diet that is high in fiber and low in saturated fat can help.

"Some people can lower their cholesterol through diet and exercise, but others can't," he added. "Heredity plays an important role."

Parmley will also discuss some of medicines that are available to lower cholesterol as well as the effectiveness of complimentary therapies like niacin and garlic.

Heart Surgery

"When other treatments don't work, surgery may be the best option," Walkes said. "Sometimes coronary artery disease progresses to the point where nothing else is effective."

He will talk about some of the surgical options available for coronary artery disease, including coronary bypass surgery, which creates a path around the blocked artery so blood can flow to the heart.

The surgery can be performed either with the heart stopped, referred to as "on pump" because a machine is used to pump the blood, or with the heart still beating, referred to as "off pump," according to Walkes.

He prefers to perform the surgery off pump because it leads to less blood loss, fewer complications like memory loss, and shorter hospital stays.

"Allowing the heart to beat naturally during surgery is so much better for the patient," he explained. "It used to be that all bypass surgeries were performed on pump. But now 90 percent of the procedures we are doing are off pump, and we are seeing better results."

Walkes said that while he will encourage participants to take the necessary steps to prevent heart disease, there are surgical options available that can improve the quality of life for people with advanced heart disease.

Get the Heart Help You Need

To learn more about the Heart Program at Washington Hospital, visit www.whhs.com/heart or call (800) 963-7070 for a physician referral.